We at Bellevue and in our city have continued to welcome and serve the newest immigrants whereas many across our country and world have been hostile and rejected immigration.

You each have seen hundreds of prisoners, victims of violence and thought with horror about the deaths of Trayvon Martin, Michael Brown, Tamir Rice and Eric Garner.

We understand what Dr. Martin Luther King, Jr. (1929—1968 ) said about the lack of universal healthcare. Its absence emphasizes that

“Of all the forms of inequality, injustice in health care is the most shocking and inhumane form of societal failure”

The trials and tribulations of the Affordable Care Act are a reminder of our failure to meet the health needs of our patients.

Even as emergency physicians who devote ourselves to the present, we recognize that our roots are in the past and our hopes in the future

We educate ourselves, our residents and students in science, social policy, global health, population and personal health

We share education with you not to foster the development of a structured well defined role in this profession, but for a responsibility that will change its characteristics as you age and permit the utilization of your remarkable adaptive skills so as to perform tasks that have not yet been defined.

We are collectively responsible as activists to address the failures in our systems that limit the physical and psychological wellbeing of the members of our communities

I would like to reflect on two other significant transformative experiences that occurred during your careers at Bellevue/NYU

You were faced with the existential crises associated with Hurricane Sandy’s effects on the New York City hospitals in which you worked and of our patients who had lived or worked in the West African countries faced with the existential threats of Ebola

The thoughts of two great scientists Albert Einstein and Werner Heisenberg come to mind

Werner Heisenberg could easily have reflected on the uncertainty exemplified by the conditions under which you worked in January 2013

The Manhattan VA hospital had no emergency department or inpatient service

The Tisch hospital had no emergency department, opened an Urgent Care Center and an Observation Ward while the hospital functioned

Bellevue had no hospital, an active free standing ED and a robust outpatient department

Albert Einstein could have reflected on the value of your education as he stated that it is that which

“remains after one has forgotten what one has learned in school.”

The great challenge and opportunity of the educator in emergency medicine are to reveal to learners the broader meaning of their experiences. These experiences will be key moments in your career forever and the associated uncertainties will prepare you for future “never before seen” events.

The immediacy of patient predicaments in the Emergency Department safety net affords less opportunity for learners to intellectually distance themselves from their patients than in other settings

You bear responsibility for creating solutions for the complex challenges to ensure sustainable access to quality care for all

I believe that support of the training mission of public hospitals is essential to sustaining the integrity of American medicine and the health of the population served

Nowhere are the root causes of health and health care disparities more discernible or better able to forge among trainees a lifelong commitment to advancing the whole population’s health

In the public hospital we are chronically underresourced and in a state of crisis

The chasm between rich and poor is evident as you traverse 30th street while walking First Avenue

We recognize the obvious needs of the tens of millions of Americans without healthcare insurance

It is essential to acknowledge and support the public hospital systems’ contribution to the care of the uninsured and to the development of your skills, idealism, professionalism and spirit of inquiry as the physicians of our future

We believe that your medical training prepares you for secure linkages to the community needs and the skills of your professional collaborators

As a member of a team you have been trained not be judged solely by your efforts, but by your capacity to elevate the performance of those who surround you

In the midst of the quantification of your medical experiences we hope you have learned that the quality of your professionalism is what matters

How much responsibility you take for each patient?

How much you offer to the unbefriended?

It is not the number of minutes or number of tests for each patient, but the breadth of your smile, the warmth of your hand and the expansiveness of your humanity.

These efforts will allow the patient adequate assurance and trust in you to ask the questions essential to secure a pathway to health.

William Osler, more than 100 years ago said

“it is much more important to know what sort of patient has the disease than to know what sort of disease the patient has.”

I am exceptionally optimistic about your futures and the potential of medicine to give you long lasting pleasure, constant enjoyment, intellectual and social challenges and unparalleled opportunities for continuing creativity

Your job offers you infinite potential to design your career to meet societal and personal demands simultaneously. In so doing I believe you will maintain your greatest strengths and avoid pessimism, materialism and burnout.

We are proud to have helped you prepare to prosper in this complex environment

The future of medicine is dependent on you to become revolutionary forces for essential change in our society.

You are strong, intelligent, wise, passionate, resilient and tested by these last four years

We are committed to you, but also commit to yourself to think, meditate, slow down, run or walk or “cultivate your garden”. It will guarantee the balance necessary for success.

Your commitment to each other into the future will be of the utmost importance

Thank you, we are counting on all of you the graduates of 2015. Congratulations!